Endosalpingiosis

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Endosalpingiosis is a benign entity that can be confused for cancer.

Endosalpingiosis
Diagnosis in short

Endosalpingiosis. H&E stain.

LM cystic lesion with ciliated epithelium surrounded by fibrous stroma, psammoma bodies
LM DDx endometriosis, serous carcinoma, adenocarcinoma, peritoneal inclusion cyst
Site peritoneum, omentum, lymph node (rare)

Clinical history may be associated with endometriosis; incidental finding
Prognosis benign

General

  • Benign entity that may lead to a misdiagnosis of adenocarcinoma[1] or serous carcinoma.
  • The clinical significance of endosalpingiosis is not definitively settled; opinions differ on whether it is:
    1. associated with pelvic pain,[2] or
    2. an incidental finding discovered in the course of investigating something else (pelvic pain, menstrual irregularities, infertility).[3]

Microscopic

Features:[4]

  • Cystic lesions with:
    • Ciliated (tubal type) epithelium, without endometrial stroma.
      • Endosalpingiosis is surrounded by fibrous stroma; tubal type epithelial surrounded by ovarian stroma is a variant of endometriosis.
  • Associated with psammoma bodies.[5]

Notes:

  1. Not associated with hemorrhage.[6]
  2. In a lymph node, endosalpingiosis may be misinterpreted as a metastasis![7]

DDx:[8]

Images

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OVARIAN FOSSA, RIGHT, BIOPSY:
- ENDOMETRIOSIS.
- ENDOSALPINGIOSIS.
- FIBROADIPOSE TISSUE PARTIALLY COVERED BY MESOTHELIUM. 

See also

References

  1. Lin O (May 2009). "Challenges in the interpretation of peritoneal cytologic specimens". Arch. Pathol. Lab. Med. 133 (5): 739–42. PMID 19415948.
  2. deHoop, TA.; Mira, J.; Thomas, MA. (Oct 1997). "Endosalpingiosis and chronic pelvic pain.". J Reprod Med 42 (10): 613-6. PMID 9350013.
  3. Heinig, J.; Gottschalk, I.; Cirkel, U.; Diallo, R. (Jun 2002). "Endosalpingiosis-an underestimated cause of chronic pelvic pain or an accidental finding? A retrospective study of 16 cases.". Eur J Obstet Gynecol Reprod Biol 103 (1): 75-8. PMID 12039470.
  4. URL: http://radiographics.rsna.org/content/29/2/347.full. Accessed on: 27 May 2010.
  5. Hallman KB, Nahhas WA, Connelly PJ (September 1991). "Endosalpingiosis as a source of psammoma bodies in a Papanicolaou smear. A case report". J Reprod Med 36 (9): 675–8. PMID 1774734.
  6. URL: http://radiographics.rsna.org/content/29/2/347.full. Accessed on: 27 May 2010.
  7. Corben, AD.; Nehhozina, T.; Garg, K.; Vallejo, CE.; Brogi, E. (Aug 2010). "Endosalpingiosis in axillary lymph nodes: a possible pitfall in the staging of patients with breast carcinoma.". Am J Surg Pathol 34 (8): 1211-6. doi:10.1097/PAS.0b013e3181e5e03e. PMID 20631604.
  8. Rosenberg, P.; Nappi, L.; Santoro, A.; Bufo, P.; Greco, P. (Mar 2011). "Pelvic mass-like florid cystic endosalpingiosis of the uterus: a case report and a review of literature.". Arch Gynecol Obstet 283 (3): 519-23. doi:10.1007/s00404-010-1700-1. PMID 20931212.